Effect of Amlodipine, Benidipine and Lercanidipine Monotherapy on Pulse Pressure: A Sub-Group Analysis of the Large HYT Survey

Background and Objective: High blood pressure (BP) in elderly patients is associated with arterial stiffness, which in turn increases central SBP and pulse pressure (PP). The PP, assessed with accurate methods or as brachial SBP-DBP (bPP), triggers target organ damage and cardiovascular outcomes. Considering this relationship, PP is an important treatment target. Dihydropyridine calcium blockers and renin-angiotensin-aldosterone inhibitors decrease, both, brachial and central PP. The aim of this study was to evaluate the changes in bPP obtained in hypertensive patients. Materials and Methods: The hypertensive patients were treated for 6 months, with amlodipine, (10 mg/day), benidipine (8 mg/day) and lercanidipine (10 mg/day). Pulse pressure, blood pressure, blood pressure control values of lercanidipine, benidipine and amlodipine groups were compared. The statistical analysis of the data was performed using the software (SAS version 9.0). A value of p<0.05 was considered statistically significant. Results: At the end of the follow-up, bPP was decreased by 8.9 mm Hg with amlodipine, 7.0 mm Hg with benidipine and 10.6 mm Hg with lercanidipine, with a statistically significant difference between benidipine and both amlodipine and lercanidipine (p<0.05). No significant difference was obtained between amlodipine and lercanidipine. All the drugs also lowered BP, however, amlodipine and benidipine, decreased less than lercanidipine SBP (p<0.05). Conclusion: Current results suggested a lesser potential cardioprotective effect of benidipine, compared with amlodipine and lercanidipine.